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Fragmentation and choreography: caring for a patient and a chart during childbirth

Published:11 February 2012Publication History

ABSTRACT

CSCW has long been concerned with how work is coordinated. A rich body of literature examines the mechanisms underlying cooperative work and the articulation of discrete tasks into meaningful sequences of action. However, there is less treatment of how workers balance multiple streams of work at once. In hospitals, the introduction of Health Information Technologies coupled with increased requirements for documentation means that workers must simultaneously care for and integrate two work trajectories: that related to the patient and that related to the medical record. Using data from an ethnographic study of labor & delivery nurses in a mid-size hospital, I describe the situated, embodied, and effortful work of coordinating multiple streams of action into a single coherent performance of work, a process I refer to as choreography, and present a number of choreography practices. I then describe implications of this perspective for CSCW.

References

  1. Allen, T. (1977). Managing the flow of technology. Cambridge, MA: MIT Press.Google ScholarGoogle Scholar
  2. Armijo, D., McDonnell, C., & Werner, K. (October 2009). Electronic Health Record Usability: Evaluation and Use Case Framework. Rockville, MD: Agency for Healthcare Research and Quality.Google ScholarGoogle Scholar
  3. Ash, J. S., Berg, M., & Coiera, E. (2004). Some unintended consequences of information technology in health care. JAMIA, 11(2), 104--112.Google ScholarGoogle Scholar
  4. Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in Nursing Practice. New York: Springer.Google ScholarGoogle Scholar
  5. Bardram, J. E., & Bossen, C. (2005). Mobility work: the spatial dimension of collaboration at a hospital. Computer Supported Cooperative Work, 14(2), 131--160. Google ScholarGoogle ScholarDigital LibraryDigital Library
  6. Berg, M. (1996). Practices of reading and writing: the constitutive role of the patient record in medical work. Sociology of Health & Illness, 18(4), 499--524.Google ScholarGoogle ScholarCross RefCross Ref
  7. Berg, M., & Bowker, G. (1997). The multiple bodies of the medical record: toward a sociology of an artifact. The Sociological Quarterly, 38(3), 513--537.Google ScholarGoogle ScholarCross RefCross Ref
  8. Bowker, G.C., & Star, S.L. (1999). Sorting Things Out. Cambridge: The MIT Press.Google ScholarGoogle Scholar
  9. Chambliss, D.F. (1996). Beyond Caring. Chicago: The University of Chicago Press.Google ScholarGoogle Scholar
  10. Chen, Y., Ngo, V., Harrison, S., & Duong, V. (2011). Unpacking exam-room computing: negotiating computer-use in patient-physician interactions. CHI'11, 3343--3352. Google ScholarGoogle ScholarDigital LibraryDigital Library
  11. Corbin, J., & Strauss, A. (2008). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Los Angeles: Sage.Google ScholarGoogle Scholar
  12. Dickerson, K., & Manheimer, E. (1998). The Cochrane Collaboration: evaluation of health care and services using systematic reviews of the results of randomized controlled trials. Clin Obst & Gyn, 41(2), 315--331.Google ScholarGoogle ScholarCross RefCross Ref
  13. Emerson, R.M., Fretz, R.I., & Shaw, L.L. (1995). Writing Ethnographic Fieldnotes. Chicago: The University of Chicago Press.Google ScholarGoogle Scholar
  14. Dourish, Paul: Where the Action Is: The Foundation of Embodied Interaction, MIT Press, Cambridge, Mass., 2001. Google ScholarGoogle ScholarDigital LibraryDigital Library
  15. Heath, C., Hindmarsh, J., & Luff, P. (1999). Interaction in isolation: the dislocated world of the London Underground train driver. Sociology, 33(3), 555--575.Google ScholarGoogle ScholarCross RefCross Ref
  16. Feldman, M. (2000). Organizational routines as a source of continuous change. Organization Science, 11(6), 611--629. Google ScholarGoogle ScholarDigital LibraryDigital Library
  17. Feldman, M., & Pentland, B. (2003). Reconceptualizing organizational routines as a source of flexibility and change. Administrative Science Quarterly, 48(1), 94--118.Google ScholarGoogle Scholar
  18. Ford, E.W., Menachemi, N. P., Thad, M. (2006). Predicting the adoption of electronic health records by physicians: when will health care be paperless? JAMIA, 13(1), 106--112.Google ScholarGoogle Scholar
  19. Gonzalez, V. and Mark, G. (2004). Constant, Constant, Multi-tasking Craziness: Managing Multiple Working Spheres. Proceedings of ACM CHI'04, 113--120. Google ScholarGoogle ScholarDigital LibraryDigital Library
  20. Kellogg, K.C., Orlikowski, W.J., & Yates, J. (2006). Life in the trading zone: structuring coordination across boundaries in postbureaucratic organizations. Organization Science, 17, 22--44. Google ScholarGoogle ScholarDigital LibraryDigital Library
  21. Klein, H., & Myers, M. (1999). A set of principles for conducting and evaluating interpretive field studies in information systems. MIS Quarterly, 23(1), 67--93. Google ScholarGoogle ScholarDigital LibraryDigital Library
  22. Mark, G., Gonzalez, V.M., Harris, J. (2005). No task left behind?: examining the nature of fragmented work. Proceedings of the SIGCHI Human factors 05. Google ScholarGoogle ScholarDigital LibraryDigital Library
  23. McQuaid, L. et Al. (2010). Socio-technical considerations in epilepsy electronic patient record implementation. Int J Med Informatics, 79(5), 349--360.Google ScholarGoogle ScholarCross RefCross Ref
  24. Mentis, H. M., Reddy, M., & Rosson, M. B. (2010). Invisible emotion: information and interaction in an emergency room. CSCW'10, 311--320. Google ScholarGoogle ScholarDigital LibraryDigital Library
  25. Okhuysen, G.A., & Bechky, B.A. (2009). Coordination in organizations: an integrative perspective. The Academy of Management Annals, 3(1), 463--502.Google ScholarGoogle ScholarCross RefCross Ref
  26. Ornstein, S.M., Oates, R.B., & Fox, G.N. (1992). The computer-based medical record: current status. J Family Prac, 36(3), 556--565.Google ScholarGoogle Scholar
  27. Reddy, M. 2002. A Finger on the pulse. temporal rhythms and information seeking in medical work. CSCW'08, 344--353. Google ScholarGoogle ScholarDigital LibraryDigital Library
  28. Schmidt, K. (2011). Cooperative work and coordinative practices. New York, New York; Springer. Google ScholarGoogle ScholarDigital LibraryDigital Library
  29. Star, S.L., & Griesemer, J.R. (1989). Institutional ecology, "translations" and boundary objects. Social Studies of Science, 19, 387--420.Google ScholarGoogle ScholarCross RefCross Ref
  30. Strauss, A., Fagerhaugh, S., Suczek, B., & Wiener, C. (1997). The Social Organization of Medical Work. Chicago: The University of Chicago Press.Google ScholarGoogle Scholar
  31. Strauss, A. (1988). The articulation of project work: an organizational process. Sociological Quarterly, 29(2), 163--178.Google ScholarGoogle Scholar
  32. Suchman, L. A. (1983). Office procedure as practical action: models of work and system design. ACM Transactions on Office Information Systems, 1(4), 320--328. Google ScholarGoogle ScholarDigital LibraryDigital Library
  33. Suchman, L.A. (1987). Plans and Situated Actions. Cambridge: Cambridge University Press.Google ScholarGoogle Scholar
  34. Tang, C.M. & Carpendale, S.T. Evaluating the deployment of a mobile technology in a hospital ward. CSCW'08, 205--214. Google ScholarGoogle ScholarDigital LibraryDigital Library
  35. Timmermans, S., & Berg, M. (2003). The Gold Standard: The Challenge of Evidence Based Medicine and Standardization in Health Care. Philadelphia: Temple University Press.Google ScholarGoogle Scholar
  36. Whyte, W. H. (1980). The Social Life of Small Urban Spaces. New York: Project for Public Spaces Inc.Google ScholarGoogle Scholar
  37. Wiener, C. L. (2000). The Elusive Quest: Accountability in Hospitals. New York: Walter de Gruyter.Google ScholarGoogle Scholar

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